Combining results from 28 studies and over 4,000 patients, researchers found that keyhole anti-reflux surgery gives lasting symptom relief in 80–90% of patients even after 10 years, with 60–70% able to stop taking daily acid medication for good. Very few patients (5–8%) needed another operation, and quality of life was notably better than for patients managed with medication alone.
A comprehensive meta-analysis of 28 studies and over 4,000 patients confirmed that laparoscopic fundoplication achieves durable symptom control in 80–90% of patients at 10 years, with 60–70% remaining off PPIs at long-term follow-up. Reoperation rates were low (5–8%) and quality of life scores significantly exceeded those of patients on continuous medical therapy.
Looking at national data on complex, large hiatal hernia repairs, researchers found that surgeons who perform more than 20 of these operations a year had far fewer complications: only 4% needed to switch to open surgery, compared to 14% for less experienced surgeons, along with shorter hospital stays and fewer major complications overall. This reinforces why complex hernia repairs are best done at high-volume centres.
A national database analysis demonstrated a strong inverse relationship between surgeon volume and morbidity in giant paraesophageal hernia repair — high-volume surgeons (>20 cases/year) had significantly lower conversion rates (4% vs. 14%), shorter hospital stays, and fewer major complications. The findings reinforced the importance of referral to experienced centres for complex hernia repair.
In patients with advanced esophageal cancer, adding an immunotherapy drug (pembrolizumab) to standard chemotherapy extended median survival from about 10 months to 12.4 months. The benefit was largest in tumours with a specific marker (PD-L1), which is now tested for to help guide first-line treatment decisions.
Updated analysis of the KEYNOTE-590 trial confirmed that adding pembrolizumab (immunotherapy) to platinum-based chemotherapy significantly improved overall survival in advanced esophageal cancer (median OS 12.4 vs. 9.8 months; HR 0.73). The benefit was most pronounced in PD-L1 CPS ≥10 tumours, shaping the standard of care for patients presenting with unresectable or metastatic disease.
For cancer at the junction of the stomach and esophagus, a newer 4-drug chemotherapy combination (FLOT), given both before and after surgery, improved 5-year survival to 45%, compared to 36% with an older chemotherapy regimen. FLOT is now the standard chemotherapy approach at most high-volume centres for this type of cancer.
Five-year follow-up of the FLOT4 trial confirmed the survival advantage of perioperative FLOT chemotherapy (fluorouracil, leucovorin, oxaliplatin, docetaxel) over ECF/ECX for resectable gastroesophageal junction and gastric adenocarcinoma (5-year OS 45% vs. 36%). FLOT is now the standard perioperative regimen at most high-volume centres.
This landmark trial was the first to show that adding immunotherapy to chemotherapy before lung cancer surgery dramatically increased the chance of eliminating the tumour beforehand — 24% versus 2% — and extended the time before cancer returned. It established immunotherapy plus chemotherapy as the new standard treatment before surgery for many lung cancer patients.
The landmark CheckMate 816 phase III trial demonstrated that adding nivolumab to neoadjuvant chemotherapy before surgery for stage IB–IIIA NSCLC significantly improved pathological complete response (24% vs. 2.2%) and event-free survival (31.6 vs. 20.8 months). The trial established immunotherapy + chemotherapy as the new standard pre-operative regimen for resectable lung cancer.
Looking at over 8,000 lung cancer surgery patients nationally, researchers found that robotic lung removal had less than half the rate of needing to switch to open surgery compared to standard keyhole (VATS) surgery — 2.3% versus 5.1% — along with less blood loss and a shorter hospital stay, while survival and thoroughness of cancer removal were the same.
A propensity-matched analysis of 8,400 patients from a national thoracic surgery database found robotic lobectomy was associated with lower conversion rates to open thoracotomy (2.3% vs. 5.1%), reduced blood transfusion requirements, and shorter length of stay compared to VATS, with equivalent 30-day mortality and oncologic lymph node yield.